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DOI: http://dx.doi.org/10.21088/potj.0974.5777.11218.6

Abstract

Symptoms of the upper extremity, sometimes, doesn’t co­relate with cervical radiculopathy or with peripheral nerve involvement. When an ideal examination excludes the probable diagnosis, comparing the symptoms and its history could possibly lead to the striking remembrance of T4 syndrome. According to Grieve, mobilization of the T4 vertebra, reproduces or eliminates the symptoms. The patient was a 43­year­old lady teacher, presented to the physiotherapy outpatient department, with the chief complaint of neck pain and tingling sensation in the left hand for 6 months. Her pain got aggravated while writing on the blackboard and while lifting weights. And eased with hot water fermentation. No positive findings to rule out for any cervical pathology or peripheral nerve involvement. Thoracic screw thrust technique was adopted to relieve pain and to reduce tingling sensation in the left hand for a patient with T4 syndrome. Following 5 sessions of Thoracic screw thrust technique, her scores of NRS for blackboard writing was reduced from 7/10 to 3/10 and for weight lifting from 8/10 to 3/10. And score for Neck Disability Index reduced from 46% to 35% (Driving domain was excluded). This case report describes the successful application of Thoracic screw thrust technique in T4 syndrome. It will probably establish an evidence of this manual therapy technique in T4 syndrome. This report will possibly also emphasize on the differential diagnosis for neck pain and the requirement of an ideal examination for the same.

Keywords: Neck Pain; T4 Syndrome; Screw Thrust Manipulation.

 

Corresponding Author : Girija Murugan, Masters Student, Department of Orthopedic Physiotherapy, Dr. APJ Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra 437376, India.